, 2012). Through this grant, the Santa Clara County Public Health Department led efforts aimed at decreasing youth access to tobacco and exposure to tobacco advertising. As CDC Director Thomas Frieden noted in his 2010 article, interventions that alter the environmental TSA HDAC context in ways that become more supportive of health and health behavior will be more effective in creating

long-term sustainable change (Frieden, 2010). The county’s goals were: to reduce illegal youth access to tobacco by implementing a policy requiring tobacco retailers in unincorporated Santa Clara County to obtain an annual permit to sell any type of tobacco product while increasing tobacco

enforcement; and to implement interventions to reduce youth exposure to tobacco near schools and other tobacco retailers. This paper evaluates the number and location of tobacco retailers, and the level of enforcement and compliance of tobacco sales regulations within unincorporated Santa Clara County following implementation of these structural interventions. Data was evaluated using three different methods: (1) geographic information systems1 (GIS) mapping of tobacco retailers; (2) observational surveys of the tobacco retail environment; and (3) enforcement surveys. Santa Clara County is located in the southern San Francisco Bay Area and Akt inhibitor has a population of 1.8 million residents (U.S. Census Bureau, 2010). The county is ethnically diverse with 35.2% Digestive enzyme white, 2.4% black, 26.9% Latino, and 31.7% Asian residents (U.S. Census Bureau, 2010). There are 15 incorporated cities in the County, ranging in size from 945,942 in San Jose to 3341

in Monte Sereno (U.S. Census Bureau, 2010). The population of the unincorporated portion of the county is 89,960 (U.S. Census Bureau, 2010). In California, there are approximately 36,700 licensed tobacco retail stores, one for every 254 children under age 18 (California Department of Public Health, California Tobacco Control Program, 2012). Santa Clara County has nearly 1600 retailers, which equates to about one for every 268 children under 18 (California Board of Equalization, 2010 and United States Census Bureau, 2010). To sell tobacco, California retailers must acquire a state-issued license from the California Board of Equalization, the statewide tobacco permitting administrative agency, at a one-time cost of $100, with no charge to renew. Tobacco retailers are spread throughout urban, suburban, and rural pockets of the unincorporated areas of Santa Clara County. In the Santa Clara County unincorporated areas, there were 36 tobacco retailers operating at the start of the intervention.